March the 15th saw the publication of a new memoir – ‘Underneath the Lemon Tree’by Mark Rice-Oxley, an assistant news editor on the foreign desk of The Guardian newspaper. It is an important book. Seeming to ‘have it all’ – great job, marriage, children – Mark was as surprised as everyone around him when he succumbed to mental illness.

I first learned about the story as Mark and his wife Sharon embarked on the always necessary promotional tour of radio stations and social media outlets. At a time when we are faced with many stories of distress – whether caused by health, economics or accident – pieces relating to ‘Underneath the Lemon Tree’ stood out for me as a brutally honest expose of the potential dangers inherent in the life many lead today. Fast-paced, hard-working, physically exhausting and apt to bleed into time available for any family willing to stay around, it is a typically (but not exclusively) male existence. Perhaps due to guilt as they struggle with traditional roles, greater sensitivity or just ‘because’, women are much more likely to approach their GP about their feelings – depression is diagnosed in three times more women than men. In a book for everyone, whether already diagnosed or yet to recognise an issue, Mark highlights the destructive nature of trying to have it all….

Mark kindly agreed to break from a hectic schedule of book promotion to answer a few questions for ‘No wriggling’.

Hi Mark – thanks for agreeing to write a few words for my blog. Firstly, could you give me a brief description of the life you were living before you became ill?

Mark

I was a hyper-busy working father, three small children, full-time job, freelance commitments, amateur musician. We had three children (and one miscarriage) in five years, so I like to reflect on five years, four pregnancies, three kids, two jobs (regular and freelance) one wife and no life.

Before you experienced depression first hand, what was your view of those with mental health issues? Do you think those views were from a particularly ‘male’ perspective? (feeling the need to be strong perhaps?)

For me, depression was for other people. I simply didn’t have time for it. And I thought as I had nothing to be sad about that I would be immune. I didn’t realise that depression is also bound up in stress, adrenalin and overexertion – in essence, it’s the body’s way of getting a very important message through. And I got the message, loud and clear. I don’t think I approached this from a particularly ‘male’ angle. I’m not a very bloky bloke and was actually quite surprised when I learned that three times as many women as men ‘present’ with depression.

How have those views changed?

I’m a bit of an evangelist now. Prevention is better than cure. I can see men all around me carrying on as if they have some kind of godlike immunity, and I want to say to them ‘read a few chapters of my book and rethink your life.’ I will always be prone to this illness now. But if only others can be made aware, they can stop themselves before it’s too late.

Reading the prologue to Underneath the Lemon Tree it is clear that depression hit you in a very physical way. When did you first realise something was seriously wrong?

I was aware in September 2009 that something was definitely not right, but I didn’t know what it was. It was physical – lethargy, mild panic, early waking, headache – but nothing so urgent that you could use to persuade others – my family, my GP – that something was amiss. It wasn’t until my birthday weekend in October 2009 that it became absolutely unignorable.

You have tried a number of treatments in the past two years, with more or less success; but from a medical or psychotherapeutic perspective what do you think has helped you most?

It’s hard to say because you try half a dozen things all at once and are not too sure which has helped the most. But for me, meditation, acceptance and curiosity have been the holy trinity, and psychotherapy helped me to understand that. Meditation/mindfulness because it stops you getting carried away and slipping back into old frenetic habits; acceptance because you can’t struggle against this or you make it worse; and curiosity because I’ve needed to work out why I am the way that I am in order to change things and prevent relapse.

The other tactics which helped with the symptoms (if not the cause) included: medication, exercise, gentle socialising, time, love, patience and, yes, writing!

Clearly you adore your family. Have you been able to talk to those closest to you about how they coped with caring for you during your darkest times?

My wife and I have always shared everything; we have talked so much about this and not just about me – but about how it affected her. We’ve also had short sessions with the children, who can be quite perspicacious despite their years. My eight-year-old asked me the other day: “How did you look after us when you were ill?” I found that hard to answer.

It isn’t long since your breakdown (although I understand that is not a term doctors use anymore it is clear you felt, as I have, ‘broken’ in some way) – was writing this book part of your ‘recovery’ process or did you have other reasons for setting everything out so explicitly?

Writing is therapy. It always has been for me. It is the way we bring order to a chaotic world, and there’s nothing more chaotic than the mind when it is on the blink. But there were other reasons for writing: I hunted for a book like this early in my illness, seeking reassurance and instruction on what I could expect. I wanted to write a book for people descending into this illness in 2012. I also wanted to create a talking point. I believe mental illness is a bit like homosexuality in the 1950s – a shameful secret that most of us keep hidden. This plainly doesn’t help – sufferers need to be open in order to recover and society needs to understand this scourge a lot better than it does.

I would describe much of your writing as poetic and at times you seem almost to pour your feelings onto the page. As a journalist have you always had that creative approach to writing?

Although I am a journalist, I have rarely had the chance to write creatively like this. News writing is a science, not an art, and it’s often frustrating to be limited to 700w. I think some of that frustration, built up over 20 years, came tumbling out during ‘lemon tree'; I do have a poetic sensibility, can hear the beauty in the cadence of words and have always had a fascination for the different modes of expression. Sometimes short sentences work. Sometimes you feel the need to be more lyrical. I do very much hope to write again, but hopefully next time it won’t be about myself.

And finally, can you give me the background to your book’s haunting title, ‘Underneath the Lemon Tree’?

The lemon tree was my trusty companion throughout the ordeal. We felt the image was bang on and the metaphor worked nicely too. I’m kind of sorry about the way it all turned out (the lemon tree died…), but c’est la vie.

Sincere thanks to Mark for his time. Underneath the Lemon Tree by Mark Rice-Oxley is a terrific book and is available from Amazon and all good bookshops RRP £13.99.

Great work, Mark. ‘Writing is therapy…’ is a line that resonates with me – almost being the title of my mental health novel, in fact. And it’s encouraging – as well as slightly astonishing – to think that when that was written a short five years ago but before the current wave of publicity challenging the mental health stigma, I had to disguise the biographical details by changing sex!

dear mark i have been suffering with depression for 5years now i have just read your book it isvery good but it doesnt help with anyone who has been suffering this illness for i think about people all the time with this terrible illness that time thank you for a interesting book take care les